Journal article
Profound hypocalcaemia in a patient being anticoagulated with citrate for continuous renal replacement therapy
Anaesthesia, Vol.64(12), pp.1363-1366
2009
Abstract
Citrate, as an anticoagulant for continuous renal replacement therapy in critically ill patients, has some potential advantages over heparin, including a prolonged dialysis filter life and reduced risk of bleeding. The key parameter involved in monitoring the adequacy and safety of citrate anticoagulation during continuous renal replacement therapy pertains to the ionised and total plasma calcium levels. We report a case of severe systemic hypocalcaemia during continuous renal replacement therapy with citrate anticoagulation resulting from relentless sequestration of calcium due to undiagnosed evolving rhabdomyolysis. Although excessive systemic citrate accumulation can also cause hypocalcaemia, this complication was not observed in our patient. While an acceptable lower limit of ionised calcium remains unknown, severe rhabdomyolysis needs to be considered when a patient's ionised calcium levels are not responsive to standard calcium replacement therapy during continuous renal replacement therapy using citrate anticoagulation in critically ill patients.
Details
- Title
- Profound hypocalcaemia in a patient being anticoagulated with citrate for continuous renal replacement therapy
- Authors/Creators
- D.J.R. Morgan (Author/Creator)K.M. Ho (Author/Creator) - The University of Western Australia
- Publication Details
- Anaesthesia, Vol.64(12), pp.1363-1366
- Publisher
- Wiley
- Identifiers
- 991005543511407891
- Copyright
- © 2009 The Authors
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.55 Urology & Nephrology - General
- 1.55.830 Acute Kidney Injury
- Web Of Science research areas
- Anesthesiology
- ESI research areas
- Clinical Medicine